Fall risk screening in the elderly: A comparison of the minimal chair height standing ability test and 5-repetition sit-to-stand test

• We compared two fall risk-screening instruments for use in clinical settings.
• The instruments were equally effective for the overall elderly population.
• The 5R-STS was more effective for participants with arthritis.
• The MCHSAT was more effective for those with a history of cardiac disease or stroke.
• The MCHSAT and 5R-STS are equally suitable for implementation in clinical settings.

BackgroundSuccessfully identifying older adults with a high risk of falling can be complicated, time consuming and not feasible in daily medical practice. This study compared the effectiveness of the Minimal Chair Height Standing Ability Test (MCHSAT) and 5-repetition sit-to-stand tst (5R-STS) as fall risk-screening instruments for the elderly.Methods167 community-dwelling older adults (mean age = 83.6 ± 7.3 years) were interviewed for demographics, fall history, cognition, and mobility status. MCHSAT performance was assessed using a chair whose seat height was modifiable by increments of 5 cm, starting at 47 cm and lowering after each successful attempt. 5R-STS performance was assessed by recording the time it took to rise and sit back down five consecutive times from a chair of 47 cm high. Operating Receiving Characteristic (ROC) curves and Area under the Curve (AUC) were calculated for each test as well as for sub-groups of participants classified based on medical comorbidities (e.g. cardiac disease/stroke, lower limb arthritis).ResultsThe MCHSAT and 5R-STS were equally effective fall-risk screening instruments for the overall population (AUC (95% CI) = 0.72 (0.63–0.82) and 0.73(0.64–0.81) respectively). The 5R-STS was more effective than the MCHSAT for participants suffering from lower limb arthritis (AUC (95% CI) = 0.81(0.70–0.92) and 0.71(0.58–0.85) respectively) while the opposite was true for participants with a history of cardiac disease or stroke (AUC (95% CI) = 0.59 (0.44–0.80) and 0.65 (0.47–0.84) respectively).ConclusionDue to their simplicity and quick administration time, the MCHSAT and 5R-STS are equally suitable for implementation in clinical settings.